At the Ho Chi Minh City Ear, Nose and Throat Hospital's Scientific and Technical Conference 2025, held on December 13th, Dr. Nguyen Minh Hao Hon, Head of the Nasal and Sinus Department, and his colleagues presented a report on the causes of failure in endoscopic nasal and sinus surgery and solutions to overcome them.
Accordingly, endoscopic sinus surgery (ESS) is currently the treatment of choice for chronic rhinosinusitis that is unresponsive to medical treatment. ESS significantly improves the quality of life in 80–98% of patients, substantially reducing nasal congestion, facial pain, discharge, and improving olfactory function.
However, the rate of re-surgery at these centers remains significant.
At the Ho Chi Minh City Ear, Nose and Throat Hospital, survey data from 2023-2024 on nearly 2,800 rhinoplasty cases recorded a total of 269 cases requiring re-operation due to recurrent rhinosinusitis, including patients transferred from lower-level hospitals and those treated at the hospital.
Of these, secondary mucocele after surgery accounted for 105 cases (39%), followed by recurrent chronic rhinosinusitis with 100 cases (over 37%).
Non-polyposis-related cases may be caused by obstruction of the frontal, maxillary, ethmoid, or sphenoid sinuses due to anatomical abnormalities, insufficient surgical clearance to access the lesion, or even incomplete removal of the lesion in some cases due to surgical errors.
An endoscopic sinus surgery at the Ho Chi Minh City Ear, Nose and Throat Hospital (Photo: Doctor).
Obstruction or narrowing of the drainage pathway was identified in 21 cases, mainly occurring in the frontal recess (19 cases) and sphenoid sinus (2 cases).
Of these, the most common location for mucocele was the ethmoid-frontal region with 51 cases, often tending to spread into the orbit, followed by the maxillary sinus, sphenoid sinus, Onodi cells, or lacrimal sac... In addition, doctors also recorded 63 cases of recurrent rhinosinusitis with fungal infections, including co-morbidities.
In summary, the research team found that most PTNSMX failures were directly related to surgical technique, such as insufficient incision, missed structures, and incomplete treatment of critical areas.
In addition, medical factors, comorbidities (asthma, AERD) in the patient, and the presence of biofilm are also risk factors. Furthermore, post-operative care and the patient's awareness of their condition significantly contribute to treatment effectiveness.
Dr. Nguyen Minh Hao Hon and colleagues believe that integrating modern classification systems (such as IESSC and LOEM) into the planning process is an essential step to synchronize intervention levels. This significantly reduces recurrence rates, optimizes outcomes, and improves long-term quality of life for patients.
Associate Professor, Doctor Le Tran Quang Minh, Director of the Ho Chi Minh City Ear, Nose and Throat Hospital, said that this year's conference has the theme "Diagnosis and Treatment of Ear, Nose and Throat Diseases in the Digital Transformation Era".
The conference attracted 400 delegates, including leading experts, researchers, doctors, and nurses specializing in ear, nose, and throat (ENT), comprising one plenary session and four specialized sessions (Ear - Otology - Audiology; Throat - Larynx - Head and Neck Surgery - Plastic Surgery; Nose and Sinus; ENT Nursing).
Assoc. Prof. Dr. Le Tran Quang Minh, Director of the Ho Chi Minh City Ear, Nose and Throat Hospital, reports at the conference (Photo: Hoang Le).
The conference was organized with the aim of enhancing the professional capacity of medical staff; promoting scientific research and the application of new technologies; building a network of cooperation between medical facilities, universities, and research organizations; and providing optimal solutions for the diagnosis and treatment of ear, nose, and throat diseases.
Source: https://dantri.com.vn/suc-khoe/bac-si-tiet-lo-nguyen-nhan-269-ca-mo-noi-soi-mui-xoang-o-tphcm-that-bai-20251213092302200.htm
Comment (0)